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Network Analyst in Morrisville, NC at Beacon Health Options

Date Posted: 11/26/2018

Job Snapshot

Job Description

About The Position:

The Network Analyst monitors and drives compliance with client network access performance guarantees by compiling key data sources and coordinating resolution with network access team (e.g., Contract Specialists) and producing both internal and client-facing reports to share status and remedies. 

Position Responsibilities:

  • Maintains database that tracks client performance guarantees and actions in pursuit to remedy network access gaps
  • Drives daily meetings with key constituents to close network access gaps.  If achieved—no access gaps or unmet access performance guarantees across client constituents—seeks to identify innovations that would sustain network access through cost effective solutions.
  • Coordinates with recruitment specialist and other network staff (e.g., credentialing) to close network access gaps.
  • Concatenates data across a variety of sources (e.g., out-of-network utilization, member complaints, member preference requests gathered from customer services, competitor network data from published directories, single case agreements, etc.) to develop a meaningful report of customer experience with access and to drive solutions to close network gaps.
  • Leverages data (e.g., appointment availability studies, client surveys, member surveys, geo-access reports, complaints, performance guarantee reports) to synthesize results into a meaningful client-facing report.
  •  Coordinates with data management and reporting and other internal and external entities to develop reports and solutions that are specific to client customer needs.
  • Provides input into performance guarantees and limitations to guide account management and sales/growth staff towards meaningful and manageable performance guarantees.
  • Leverages industry solutions and seeks out new technologies and innovations to tackle network access gaps. 
  • Maintains and shares knowledge of evolving industry expectations related to network adequacy and appointment availability standards with goal of Beacon Health Options as the industry leader in network adequacy and access.
  • In conjunction with internal and external stakeholders, secure executed agreements with identified out of network providers for inclusion in the Beacon Health network – Federal/Employer Division.
  • Performs reimbursement analysis on providers/facilities that are outside of the targeted rate schedule or performance standards and develop strategies for cost reductions, member needs and increasing quality.
  • Identifies opportunities for cost savings and process improvements related to the contracting process.
  • Provides general support to all network development activities and support Director with implementation requirements.
  • Strategizes with other members of the management team to ensure access and availability of providers meets current standards.
  • Collaborates with other departments to address and resolve operational issues as related to negotiated contract language.
  • Prepares reports and analyze data as directed by the Direct of Contracting or other members of the management team.
  • Adheres to all Beacon policies and procedures and standards of operations.
  • Completes all required and assigned trainings.
  • Attends all mandatory company or department meetings.
  • Reports to each scheduled shift and commence work and perform essential job function at the start of each schedule shift.
  • Displays a positive, constructive, and helpful demeanor that is conducive to a safe and respectful work environment.
  • Acts as a mentor to junior team members by leading by example and guiding with a sense of integrity and team work.
  • Assists management with identifying opportunities for staff improvement, high performing team members, and training needs of team members.
  • Assist team members and offers suggestions to improve processes, culture, or work environment.
  • Performs special projects and other duties as assigned and required.

Position Requirements:

  • Education: Bachelor’s degree required.

Relevant Work Experience: 

  • Minimum of 3 years’ experience, with direct experience in healthcare data management and reporting with direct experience in either provider relations or network recruitment.
  • Knowledge of managed care contract requirements to include state and federal regulatory requirements for Medicare and Medicaid plans and CMS guidelines.
  • Knowledgeable in Excel, Access and tools used to manage network adequacy (e.g. Geo-Access, member surveys and appointment studies).

To Apply:

Click below on “Apply for this Position” to create a profile and apply for the position

Beacon Health Options is proud to be an Equal Opportunity and Affirmative Action Employer as well as a Drug Free and Tobacco Free Work Environment.  EOE/AA/M/F/Veterans/Disabled

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